Endocrine/Reproductive Drugs - CLASSES/MECHANISMS

Question 1

Histrelin

Answer 1

GnRH analog

Pulsatile → agonist

Continuous → antagonist

Question 2

Flutamide

Answer 2

Nonsteroidal competitive androgen receptor inhibitor

Will also decreases testosterone inhibition of GnRH secretion → increase serum LH (counteract by always administering with leuprolide)

Question 3

Somatrem

Answer 3

GH analog

Question 4

Tolvaptan

Answer 4

ADH antagonist at V2 receptor (kidney)

Question 5

Spironolactone

Answer 5

Inhibits:

Steroid binding

17,20 desmolase

17-alpha hydroylase

Question 6

Alendronate

Answer 6

Bisphosphonate

Pyrophosphate analog

Binds hydroxyapatite in bone → inhibiting osteoclast activity

Question 7

Levothyroxine

Answer 7

Thyroid hormone replacement

Question 8

Pamidronate

Answer 8

Bisphosphonate

Pyrophosphate analog

Binds hydroxyapatite in bone → inhibiting osteoclast activity

Question 9

Zoledronate

Answer 9

Bisphosphonate

Pyrophosphate analog

Binds hydroxyapatite in bone → inhibiting osteoclast activity

Question 10

Nafarelin

Answer 10

GnRH analog

Pulsatile → agonist

Continuous → antagonist

Question 11

Propylthiouracil

Answer 11

Inhibit thyroid peroxidase → inhibiting the oxidation of iodide and organification and coupling of iodine → inhibition of thyroid hormone synthesis

Also inhibits 5’deiodinase → decreasing peripheral conversion tof T4 to T3

Question 12

Goserelin

Answer 12

GnRH analog

Pulsatile → agonist

Continuous → antagonist

Question 13

Cinacalcet

Answer 13

Sensitizes calcium-sensing receptor (CaSR) in parathyroid gland to circulating free calcium → decreases PTH

Question 14

Letrozole

Answer 14

Aromatase inhibitor

Decreases estradiol levels

Question 15

Mestranol

Answer 15

Estrogen

Question 16

Terbutaline

Answer 16

Beta-2 agonist → relaxes uterus

Question 17

Octreotide

Answer 17

Somatostatin analog

Inhibits release of many hormones

Decreases GI motility

Vasoconstriction

Question 18

Fludrocortisone

Answer 18

Synthetic aldosterone analog with little glucocorticoid effects

Question 19

Conivaptan

Answer 19

ADH antagonist at V2 receptor (kidney)

Question 20

Danazol

Answer 20

Synthetic androgen receptor agonist → decreasing LH and FSH secretion → decreasing growth of endometrial and breast tissue

Also:

Increases levels of C2 esterase inhibitor (deficiency enzyme in hereditary angioedema) → increasing C4 levels

Question 21

Cabergoline

Answer 21

Ergot alkaloids - D2 agonist

Stimulate D2 receptors on lactotropes → increasing DA → inhibiting prolactin release

Question 22

Triiodothyronine

Answer 22

Thyroid hormone replacement

Question 23

Leuprolide

Answer 23

GnRH analog

Pulsatile → agonist

Continuous → antagonist

Question 24

Ethinyl estradiol

Answer 24

Estrogen

Question 25

Somatropin

Answer 25

GH analog

Question 26

Exemestane

Answer 26

**Aromatase inhibitor** Decreases estradiol levels

Question 27

Pegvisomant

Answer 27

**GH antagonist:** PEGylated analog of GH → blocks action of GH on target tissue → decreasing IGF-1

Question 28

Methimazole

Answer 28

Inhibit **thyroid peroxidase** → inhibiting the oxidation of iodide and organification and coupling of iodine → inhibition of thyroid hormone synthesis

Question 29

Ketoconazole

Answer 29

Inhibits several steps in steroid synthesis

Question 30

Anastrozole

Answer 30

**Aromatase inhibitor** Decreases estradiol levels

Question 31

Minoxidil

Answer 31

**Direct arteriolar vasodilator** Used for androgenic alopecia (pattern baldness) Severe refractory hypertension

Question 32

Ritodrine

Answer 32

Beta-2 agonist → relaxes uterus

Question 33

Demeclocycline

Answer 33

ADH antagonist at V2 receptor (kidney)

Question 34

Finasteride

Answer 34

**5-alpha reductase inhibitor** Decreases conversion ot testosterone to DHT

Question 35

Oxytocin

Answer 35

Stimulates uterine contraction Stimulates contraction of myeoepithelial cells in breast

Question 36

Diethylstilbestrol (DES)

Answer 36

Estrogen

Question 37

Ibandronate

Answer 37

**Bisphosphonate** Pyrophosphate analog Binds hydroxyapatite in bone → inhibiting osteoclast activity

Question 38

Tamsulozin

Answer 38

Alpha-1 antagonist **SELECTIVE FOR ALPHA-1A RECEPTORS** (found on prostate) vs vascular alpha-1b receptors

Question 39

Risedronate

Answer 39

**Bisphosphonate** Pyrophosphate analog Binds hydroxyapatite in bone → inhibiting osteoclast activity

Question 40

Bromocriptine

Answer 40

**Ergot alkaloids - D2 agonist** Stimulate D2 receptors on lactotropes → increasing DA → inhibiting prolactin release

Question 41

Etidronate

Answer 41

**Bisphosphonate** Pyrophosphate analog Binds hydroxyapatite in bone → inhibiting osteoclast activity

Question 42

Desmopressin acetate

Answer 42

ADH analog